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NPI Code Detail

MEDICARE: MRS. MICHELLE MARIE HENSON PT

MEDICARE: MRS. MICHELLE MARIE HENSON PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT007005LPA

General Provider Information

NPI Number : 1770807695
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE MARIE HENSON PT
Provider Business Mailing Address
First Line : 5416 E LAKE RD
Second Line :
City : ERIE
State : PA
Zip : 16511-1427
Country : US
Telephone Number : 814-899-8600
Fax Number : 814-898-1910
Provider Business Practice Location Address
First Line : 5416 E LAKE RD
Second Line :
City : ERIE
State : PA
Zip : 16511-1427
Country : US
Telephone Number : 814-899-8600
Fax Number : 814-898-1910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2010
Last Update Date : 03/22/2010

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Directions to “ MRS. MICHELLE MARIE HENSON PT” Practice Location

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